Psychoactive substance disorders

ABSTRACT

2-Methyl-4-(4-methyl-1-piperazinyl)-10H-thieno- 2,3-b! 1,5!benzodiazepine, or an acid salt thereof, has pharmaceutical properties, and is of particular use in the treatment of disorders relating to the use of psychoactive substances. The compound has the following structure: ##STR1##

CROSS REFERENCE

This application is a continuation-in-part of 08/387,498, filed Feb. 13,1995, now U.S. Pat. No. 5,605,897, which was a continuation in part ofapplication Ser. No. 08/044,844, filed Apr. 8, 1993, now abandoned,which was a continuation-in-part of application serial number07/890,348, filed May 22, 1992, which issued as U.S. Pat. No. 5,229,382,which was a continuation of serial number 07/690,143, filed Apr. 23,1991.

This invention relates to novel organic compounds and the use thereof aspharmaceuticals.

Currently there are many drugs available for the treatment of disordersof the central nervous system. Amongst these drugs is a category knownas antipsychotics for treating serious mental conditions such aspsychosis, including but not limited to schizophrenia andschizophreniform illnesses. The skilled artisan will recognize thatthese psychotic conditions are characterized by hallucinations,delusions, or grossly disorganized behavior which indicate that thepatient suffers from gross impairment in reality testing. Drugs havingsaid antipsychotic activity can be useful for treating a variety ofimportant psychotic disorders. The drugs available for such conditionsare often associated with undesirable side effects, and there is a needfor better products that control or eliminate the symptoms in a saferand more effective way. Furthermore, many patients do not respond oronly partially respond to present drug treatment, and estimates of suchpartial-or non-responders vary between 40% and 80% of those treated.

Ever since antipsychotics were introduced it has been observed thatpatients are liable to suffer from drug-induced extrapyramidal symptomswhich include drug-induced Parkinsonism, acute dystonic reactions,akathisia, tardive dyskinesia and tardive dystonia. The Simpson AngusScale, Barnes Akathisia Rating Scale and Abnormal Involuntary MovementScale (AIMS) are well known scales for assessing extrapyramidalsymptoms. The great majority of drugs available for treatment ofschizophrenia are prone to produce these extrapyramidal side effectswhen used at dosages that yield a beneficial effect on the symptoms ofthe disease. The severity of adverse events and/or lack of efficacy in aconsiderable number of patients frequently results in poor compliance ortermination of treatment.

Many of the drugs are associated with a sedative effect and may alsohave an undesirable influence on the affective symptoms of the disease,causing depression. In some instances long term use of the drug leads toirreversible conditions, such as the tardive dyskinesia and tardivedystonia referred to supra.

A widely-used antipsychotic, haloperidol, is one such drug, which hasbeen reported as causing a high incidence of extrapyramidal symptoms andmay also cause tardive dyskinesia. More recently, clozapine, one of alarge group of heterocyclic antipsychotics, has been introduced with theclaim that it is free from extrapyramidal effects. However, the compoundwas found to cause agranulocytosis in some patients, a conditionresulting in a lowered white blood cell count which can belife-threatening, and it may now only be employed under very strictmedical observation and supervision.

A further group of antipsychotic compounds is that described in BritishPatent 1 533 235. These include thieno-benzodiazepines having thefollowing s tructural nucleus. ##STR2##

The lead compound from this group, flumezapine,(7-fluoro-2-methyl-10-(4-methyl-1-piperazinyl)-4H-thieno 2,3-b!1,5!-benzodiazepine), was developed to the stage of being clinicallyadministered to psychiatric patients suffering from schizophrenia. Atotal of 17 patients received treatment with flumezapine before theclinical trial was terminated after consultation with the U.S. Food andDrug Administration, because of an unacceptably high incidence of raisedenzyme levels in the treated patients. The enzyme, creatininephosphokinase (CPK), and the liver enzymes, serum glutamate oxalacetictransaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT),estimated from blood samples taken from patients, were in substantialexcess of normal values, indicating the possibility of toxicity. Inrespect of its tendency to raise liver enzyme levels, flumezapine issimilar to chlorpromazine, an antipsychotic which has long been in usebut whose safety has been called into question.

In clinical trials with flumezapine two of the patients showed theemergence of extrapyramidal side effects as measured on the AIMS scalereferred to above.

We have now discovered a compound which possesses surprising andunexpected properties by comparison with flumezapine and other relatedcompounds.

The 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b!1,5!benzodiazepine compound is of the formula ##STR3## or an acidaddition salt thereof. The free base of formula (I) is2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b!1,5!benzodiazepine.

The 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b!1,5!benzodiazepine compound has given surprising and excellent results,described in greater detail below, in experimental screens for testingactivity on the central nervous system and in clinical trials, whichresults suggest its usefulness for the relatively safe and effectivetreatment of a wide range of disorders of the central nervous system.

The results of pharmacological tests show that2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b! 1,5!benzodiazepineis an antagonist of dopamine at D-1 and D-2 receptors, and in additionhas antimuscarinic anticholinergic properties and antagonist activity at5HT-2 receptor sites. It also has antagonist activity at noradrenergicα-receptors. These properties indicate that the compound is a potentialneuroleptic with relaxant, anxiolytic and anti-emetic properties, andmay be useful in treating psychotic conditions such as, but not limitedto, schizophrenia, schizophreniform diseases and mania. At lower dosesthe compound is indicated for use in the treatment of mild anxietystates. The properties of 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno2,3-b! 1,5!benzodiazepine suggest that it would be useful in thetreatment of any pathologic psychologic condition, where delusions,hallucinations, disorganized behavior, or anxiety are consistent withmanifestation of that pathologic condition.

Pathologic psychological conditions which are psychoses or may beassociated with psychotic features include, but are not limited to thefollowing disorders which have been characterized in the DSM-III-R.Diagnostic and Statistical Manual of Mental Disorders, Revised, 3rd Ed.(1980). The DSM-III-R was prepared by the Task Force on Nomenclature andStatistics of the American Psychiatric Association, and provides cleardescriptions of diagnostic catagories. The numbers in parenthesis referto the DSM-III-R categories. The skilled artisan will recognize thatthere are alternative nomenclatures, nosologies, and classificationsystems for pathologic psychological conditions and that these systemsevolve with medical scientific progress.

Examples of pathologic psychologic conditions which may be treated using2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b! 1,5!benzodiazepineinclude, but are not limited to, Moderate Mental Retardation (318.00),Severe Mental Retardation (318.10), Profound Mental Retardation(318.20), Unspecified Mental Retardation (319.00), Autistic disorder(299.00), Pervasive Development Disorder NOS (299.80), Attention-deficitHyperactivity Disorder (314.01), Conduct Disorder, Group Type (312.20),Conduct Disorder, Solitary Aggressive Type (312.00), Conduct Disorder,Undifferentiated Type (312.90), Tourette's Disorder (307.23), ChronicMotor Or Vocal Tic Disorder (307.22), Transient Tic Disorder (307.21),Tic Disorder NOS (307.20), Primary Degenerative Dementia of theAlzheimer Type, Senile Onset, with Delirium (290.30), PrimaryDegenerative Dementia of the Alzheimer Type, Senile Onset, withDelusions (290.20), Primary Degenerative Dementia of the Alzheimer Type,Senile Onset, with Depression (290.21), Primary Degenerative Dementia ofthe Alzheimer Type, Senile Onset, Uncomplicated (290.00), PrimaryDegenerative Dementia of the Alzheimer Type, Presenile Onset, withDelirium (290.11), Primary Degenerative Dementia of the Alzheimer Type,Presenile Onset, with Delusions (290.12), Primary Degenerative Dementiaof the Alzheimer Type, Presenile Onset, with Depression (290.13),Primary Degenerative Dementia of the Alzheimer Type, Presenile Onset,Uncomplicated (290.10), Multi-infarct dementia, with Delirium (290.41),Multi-infarct dementia, with Delusions (290.42), Multi-infarct dementia,with Depression (290.43), Multi-infarct dementia, Uncomplicated(290.40), Senile Dementia NOS (290.00), Presenile Dementia NOS (290.10),Alcohol Withdrawal Delirium (291.00), Alcohol Hallucinosis (291.30),Alcohol Dementia Associated with Alcoholism (291.20), Amphetamine orSimilarly Acting Sympathomimetic Intoxication (305.70), Amphetamine orSimilarly Acting Sympathomimetic Delirium (292.81), Amphetamine orSimilarly Acting Sympathomimetic Delusional Disorder (292.11), CannabisDelusional Disorder (292.11), Cocaine Intoxication (305.60), CocaineDelirium (292.81), Cocaine Delusional Disorder (292.11), HallucinogenHallucinosis (305.30), Hallucinogen Delusional Disorder (292.11),Hallucinogen Mood Disorder (292.84), Hallucinogen PosthallucinogenPerception Disorder (292.89), Phencyclidine (PCP) or Similarly ActingArylcyclohexylamine Intoxication (305.90), Phencyclidine (PCP) orSimilarly Acting Arylcyclohexylamine Delirium (292.81), Phencyclidine(PCP) or Similarly Acting Arylcyclohexylamine Delusional Disorder(292.11), Phencyclidine (PCP) or Similarly Acting ArylcyclohexylamineMood Disorder (292.84), Phencyclidine (PCP) or Similarly ActingArylcyclohexylamine Organic Mental Disorder NOS (292.90), Other orUnspecified Psychoactive Substance Intoxication (305.90), Other orUnspecified Psychoactive Substance Delirium (292.81), Other orUnspecified Psychoactive Substance Dementia (292.82), Other orUnspecified Psychoactive Substance Delusional Disorder (292.11), Otheror Unspecified Psychoactive Substance Hallucinosis (292.12), Other orUnspecified Psychoactive Substance Mood Disorder (292.84), Other orUnspecified Psychoactive Substance Anxiety Disorder (292.89), Other orUnspecified Psychoactive Substance Personality Disorder (292.89), Otheror Unspecified Psychoactive Substance Organic Mental Disorder NOS(292.90), Delirium (293.00), Dementia (294.10), Organic DelusionalDisorder (293.81), Organic Hallucinosis (293.82), Organic Mood Disorder(293.83), Organic Anxiety Disorder (294.80), Organic PersonalityDisorder (310.10), Organic Mental Disorder (294.80), ObsessiveCompulsive Disorder (300.30), Post-traumatic Stress Disorder (309.89),Generalized Anxiety Disorder (300.02), Anxiety Disorder NOS (300.00),Body Dysmorphic Disorder (300.70), Hypochondriasis (or HypochondriacalNeurosis) (300.70), Somatization Disorder (300.81), UndifferentiatedSomatoform Disorder (300.70), Somatoform Disorder NOS (300.70),Intermittent Explosive Disorder (312.34), Kleptomania (312.32),Pathological Gambling (312.31), Pyromania (312.33), Trichotillomania(312.39), and Impulse Control Disorder NOS (312.39).

Schizophrenia, Catatonic, Subchronic, (295.21), Schizophrenia,Catatonic, Chronic (295.22), Schizophrenia, Catatonic, Subchronic withAcute Exacerbation (295.23), Schizophrenia, Catatonic, Chronic withAcute Exacerbation (295.24), Schizophrenia, Catatonic, in Remission(295.55), Schizophrenia, Catatonic, Unspecified (295.20), Schizophrenia,Disorganized, Subchronic (295.11), Schizophrenia, Disorganized, Chronic(295.12), Schizophrenia, Disorganized, Subchronic with AcuteExacerbation (295.13), Schizophrenia, Disorganized, Chronic with AcuteExacerbation (295.14), Schizophrenia, Disorganized, in Remission(295.15), Schizophrenia, Disorganized, Unspecified (295.10),Schizophrenia, Paranoid, Subchronic (295.31), Schizophrenia, Paranoid,Chronic (295.32), Schizophrenia, Paranoid, Subchronic with AcuteExacerbation (295.33), Schizophrenia, Paranoid, Chronic with AcuteExacerbation (295.34), Schizophrenia, Paranoid, in Remission (295.35),Schizophrenia, Paranoid, Unspecified (295.30), Schizophrenia,Undifferentiated, Subchronic (295.91), Schizophrenia, Undifferentiated,Chronic (295.92), Schizophrenia, Undifferentiated, Subchronic with AcuteExacerbation (295.93), Schizophrenia, Undifferentiated, Chronic withAcute Exacerbation (295.94), Schizophrenia, Undifferentiated, inRemission (295.95), Schizophrenia, Undifferentiated, Unspecified(295.90), Schizophrenia, Residual, Subchronic (295.61), Schizophrenia,Residual, Chronic (295.62), Schizophrenia, Residual, Subchronic withAcute Exacerbation (295.63), Schizophrenia, Residual, Chronic with AcuteExacerbation (295.94), Schizophrenia, Residual, in Remission (295.65),Schizophrenia, Residual, Unspecified (295.60), Delusional (Paranoid)Disorder (297.10), Brief Reactive Psychosis (298.80), SchizophreniformDisorder (295.40), Schizoaffective Disorder (295.70), Induced PsychoticDisorder (297.30), Psychotic Disorder NOS (Atypical Psychosis) (298.90),Bipolar Disorder, Mixed, Severe, without Psychotic Features (296.63),Bipolar Disorder, Manic, Severe, without Psychotic Features (296.43),Bipolar Disorder, Depressed, Severe, without Psychotic Features(296.53), Major Depression, Single Episode, Severe, without PsychoticFeatures (296.23), Major Depression, Recurrent, Severe, withoutPsychotic Features (296.33), Bipolar Disorder, Mixed, with PsychoticFeatures (296.64), Bipolar Disorder, Manic, with Psychotic Features(296.44), Bipolar Disorder, Depressed, with Psychotic Features (296.54),Bipolar Disorder NOS (296.70), Major Depression, Single Episode, withPsychotic Features (296.24), Major Depression, Recurrent with PsychoticFeatures (296.34) Personality Disorders, Paranoid (301.00), PersonalityDisorders, Schizoid (301.20), Personality Disorders, Schizotypal(301.22), Personality Disorders, Antisocial (301.70), and PersonalityDisorders, Borderline (301.83).

Preferably, an effective amount of2-methyl-4-(4-methyl-1-piperazinyl)-10thieno- 2,3-b! 1,5!benzodiazepine,or an acid addition salt thereof, is used for the treatment of ModerateMental Retardation; Severe Mental Retardation; Profound MentalRetardation; Autistic disorder; Pervasive Development Disorder NOS;Conduct Disorder, Group Type; Conduct Disorder, Solitary AggressiveType; Tourette's Disorder; Primary Degenerative Dementia of theAlzheimer Type, Senile Onset, with Delirium; Primary DegenerativeDementia of the Alzheimer Type, Senile Onset, with Delusions;Schizophrenia, Catatonic, Subchronic; Schizophrenia, Catatonic, Chronic;Schizophrenia, Catatonic, Subchronic with Acute Exacerbation;Schizophrenia, Catatonic, Chronic with Acute Exacerbation;Schizophrenia, Catatonic, in Remission; Schizophrenia, Catatonic,Unspecified; Schizophrenia, Disorganized, Subchronic; Schizophrenia,Disorganized, Chronic; Schizophrenia, Disorganized, Subchronic withAcute Exacerbation; Schizophrenia, Disorganized, Chronic with AcuteExacerbation; Schizophrenia, Disorganized, in Remission; Schizophrenia,Disorganized, Unspecified; Schizophrenia, Paranoid, Subchronic;Schizophrenia, Paranoid, Chronic; Schizophrenia, Paranoid, Subchronicwith Acute Exacerbation; Schizophrenia, Paranoid, Chronic with AcuteExacerbation; Schizophrenia, Paranoid, in Remission; Schizophrenia,Paranoid, Unspecified; Schizophrenia, Undifferentiated, Subchronic;Schizophrenia, Undifferentiated, Chronic; Schizophrenia,Undifferentiated, Subchronic with Acute Exacerbation; Schizophrenia,Undifferentiated, Chronic with Acute Exacerbation; Schizophrenia,Undifferentiated, in Remission; Schizophrenia, Undifferentiated,Unspecified; Schizophrenia, Residual, Subchronic; Schizophrenia,Residual, Chronic; Schizophrenia, Residual, Subchronic with AcuteExacerbation; Schizophrenia, Residual, Chronic with Acute Exacerbation;Schizophrenia, Residual, in Remission; Schizophrenia, Residual,Unspecified; Delusional (Paranoid) Disorder; Brief Reactive Psychosis;Schizophreniform Disorder; Schizoaffective Disorder; Induced PsychoticDisorder; Psychotic Disorder NOS (Atypical Psychosis);Bipolar Disorder,Mixed, with Psychotic Features; Bipolar Disorder, Manic, with PsychoticFeatures; Bipolar Disorder, Depressed, with Psychotic Features; BipolarDisorder NOS; Major Depression, Single Episode, with Psychotic Features;Personality Disorders, Paranoid; Personality Disorders, Schizoid;Personality Disorders, Schizotypal; Personality Disorders, Antisocial;Personality Disorders, Borderline; Hebephrenic Schizophrenia;Post-Schizophrenic Depression; Delusional Disorder; and Other PersistentDelusional Disorders.

More preferredly, 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno- 2,3-b!1,5!benzodiazepine is used to treat the following pathologicpsychological conditions including Schizophrenia, Catatonic, Subchronic;Schizophrenia, Catatonic, Chronic; Schizophrenia, Catatonic, Subchronicwith Acute Exacerbation; Schizophrenia, Catatonic, Chronic with AcuteExacerbation; Schizophrenia, Catatonic, in Remission; Schizophrenia,Catatonic, Unspecified; Schizophrenia, Disorganized, Subchronic;Schizophrenia, Disorganized, Chronic; Schizophrenia, Disorganized,Subchronic with Acute Exacerbation; Schizophrenia, Disorganized, Chronicwith Acute Exacerbation; Schizophrenia, Disorganized, in Remission;Schizophrenia, Disorganized, Unspecified; Schizophrenia, Paranoid,Subchronic; Schizophrenia, Paranoid, Chronic; Schizophrenia, Paranoid,Subchronic with Acute Exacerbation; Schizophrenia, Paranoid, Chronicwith Acute Exacerbation; Schizophrenia, Paranoid, in Remission;Schizophrenia, Paranoid, Unspecified; Schizophrenia, Undifferentiated,Subchronic; Schizophrenia, Undifferentiated, Chronic; Schizophrenia,Undifferentiated, Subchronic with Acute Exacerbation; Schizophrenia,Undifferentiated, Chronic with Acute Exacerbation; Schizophrenia,Undifferentiated, in Remission; Schizophrenia, Undifferentiated,Unspecified; Schizophrenia, Residual, Subchronic; Schizophrenia,Residual, Chronic; Schizophrenia, Residual, Subchronic with AcuteExacerbation; Schizophrenia, Residual, Chronic with Acute Exacerbation;Schizophrenia, Residual, in Remission; Schizophrenia, Residual,Unspecified; Delusional (Paranoid) Disorder; Brief Reactive Psychosis;Schizophreniform Disorder; Schizoaffective Disorder; Induced PsychoticDisorder; Psychotic Disorder NOS (Atypical Psychosis);Bipolar Disorder,Mixed, with Psychotic Features; Bipolar Disorder, Manic, with PsychoticFeatures; Bipolar Disorder, Depressed, with Psychotic Features; BipolarDisorder NOS; Major Depression, Single Episode, with Psychotic Features;Personality Disorders, Paranoid; Personality Disorders, Schizoid;Personality Disorders, Schizotypal; Personality Disorders, Antisocial;Personality Disorders, Borderline; Hebephrenic Schizophrenia;Post-Schizophrenic Depression; Delusional Disorder; and Other PersistentDelusional Disorders.

Examples of conditions which are most preferredly treated using2-methyl-4-(4-methyl-1- piperazinyl)-10H-thieno- 2,3-b!1,5!benzodiazepine include Schizophrenia, Catatonic, Subchronic;Schizophrenia, Catatonic, Chronic; Schizophrenia, Catatonic, Subchronicwith Acute Exacerbation; Schizophrenia, Catatonic, Chronic with AcuteExacerbation; Schizophrenia, Catatonic, in Remission; Schizophrenia,Catatonic, Unspecified; Schizophrenia, Disorganized, Subchronic;Schizophrenia, Disorganized, Chronic; Schizophrenia, Disorganized,Subchronic with Acute Exacerbation; Schizophrenia, Disorganized, Chronicwith Acute Exacerbation; Schizophrenia, Disorganized, in Remission;Schizophrenia, Disorganized, Unspecified; Schizophrenia, Paranoid,Subchronic; Schizophrenia, Paranoid, Chronic; Schizophrenia, Paranoid,Subchronic with Acute Exacerbation; Schizophrenia, Paranoid, Chronicwith Acute Exacerbation; Schizophrenia, Paranoid, in Remission;Schizophrenia, Paranoid, Unspecified; Schizophrenia, Undifferentiated,Subchronic; Schizophrenia, Undifferentiated, Chronic; Schizophrenia,Undifferentiated, Subchronic with Acute Exacerbation; Schizophrenia,Undifferentiated, Chronic with Acute Exacerbation; Schizophrenia,Undifferentiated, in Remission; Schizophrenia, Undifferentiated,Unspecified; Schizophrenia, Residual, Subchronic; Schizophrenia,Residual, Chronic; Schizophrenia, Residual, Subchronic with AcuteExacerbation; Schizophrenia, Residual, Chronic with Acute Exacerbation;Schizophrenia, Residual, in Remission; Schizophrenia, Residual,Unspecified; Delusional (Paranoid) Disorder; Brief Reactive Psychosis;Schizophreniform Disorder; Schizoaffective Disorder;PersonalityDisorders, Schizoid; Personality Disorders, Schizotypal; HebephrenicSchizophrenia; and Post-Schizophrenic Depression.

Examples of anxiety disorders which may more preferredly be treatedusing an effective amount of2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b!-1,5!benzodiazepine, or an acid addition salt thereof, includePsychoactive Substance Anxiety Disorder; Organic Anxiety Disorder;Obsessive Compulsive Disorder; Post-traumatic Stress Disorder;Generalized Anxiety Disorder; and Anxiety Disorder NOS.

Examples of the anxiety disorders which are most preferredly treatedusing 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno- 2,3-b!1,5!benzodiazepine include Organic Anxiety Disorder; ObsessiveCompulsive Disorder; Post-traumatic Stress Disorder; Generalized AnxietyDisorder; and Anxiety Disorder NOS.

As mentioned above, 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno2,3-b! 1,5!benzodiazepine has shown a high level of activity in theclinical evaluation of psychiatric patients suffering fromschizophrenia, and it exhibits this high activity at surprisingly lowdosage levels. The dosage levels have been found to be lower than wouldbe expected from observations of the compound made in initial tests onanimal models. Its response profile in patients follows that of knownantipsychotic agents when they have been used successfully, there beinga clear similarity between the performance of the compound and that ofknown antipsychotic agents in its ratings on the major assessment scalessuch as Brief Psychiatric Rating Scale (BPRS), and Clinical GlobalImpression (CGI).

In the first completed open (as opposed to blind) study of2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b! 1,5!benzodiazepinein schizophrenic patients, six out of eight patients who completed atleast 2 weeks of treatment showed between 66% and 87% improvement at 4weeks, as assessed on BPRS scale, at daily dosages between 5 and 30 mg.Preliminary results from a further three ongoing clinical trials nowappear to confirm this high level of efficacy and at doses lower than orat the low end of the dosage level used in the first study, for example,at 2.5 and 5 mg per day.

Moreover, although some patients have exhibited increases in hepaticenzyme levels, no patient treated to date has experienced clinicallysignificant hepatic disease. Plasma levels of creatinine phosphokinase(CPK) are lower than with flumezapine, indicating a lower adverse effecton muscular tissue. Furthermore,2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b! 1,5!benzodiazepinecauses lower elevation of prolactin levels than other currently usedneuroleptic drugs and this suggests fewer disturbances of the menstrualcycle, and less gynecomastia and galactorrhea. No substantial clinicallysignificant alteration of white blood cell count has been observed inclinical studies.

In dog toxicity studies with a closely analogous compound,2-ethyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b! 1,5!benzodiazepine,at a dosage of 8 mg/kg, it was observed that four out of eight dogsshowed a significant rise in cholesterol levels, whereas2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b! 1,5!benzodiazepinedid not show any rise in cholesterol levels.

Overall, therefore, in clinical situations,2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b!-1,5!benzodiazepine shows marked superiority, and a better side effectsprofile than prior known antipsychotic agents, and has a highlyadvantageous activity level.

The compound 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b!1,5!benzodiazepine can be used both in its free base and acid additionsalt forms. The acid addition salts are preferably the pharmaceuticallyacceptable, non-toxic addition salts with suitable acids, such as thoseof inorganic acids, for example hydrochloric, hydrobromic, nitric,sulphuric or phosphoric acids, or of organic acids, such as organiccarboxylic acids, for example glycollic, maleic, hydroxymaleic, fumaric,malic, tartaric, citric or lactic acid, or organic sulphonic acids forexample methane sulphonic, ethane sulphonic, 2-hydroxyethane sulphonic,toluene-p-sulphonic or naphthalene-2-sulphonic acid. In addition topharmaceutically acceptable acid addition salts, other acid additionsalts are included in the invention, for example, those with picric oroxalic acid, since they have potential to serve as intermediates inpurification or in the preparation of other, for example,pharmaceutically acceptable, acid addition salts, or are useful foridentification, characterization or purification of the free base.

According to a further aspect of the invention there is provided aprocess for producing a compound of formula (I) or an acid addition saltthereof, which comprises

(a) reacting N-methylpiperazine with a compound of the formula ##STR4##in which Q is a radical capable of being split off, or (b) ring-closinga compound of the formula ##STR5##

Appropriate reaction conditions and suitable values of Q can readily bechosen for these processes.

In reaction (a)the radical Q can, for example, be an amino group or amono-or dialkyl-substituted amino group (each alkyl substituent suitablycontaining 1 to 4 carbon atoms), hydroxyl, thiol, or an alkoxy,alkylthio or alkylsulphonyl group suitably containing 1 to 4 carbonatoms, for example a methoxy or methylthio group, or a halogen atom,especially a chlorine atom. Preferably, Q is amino (--NH₂), hydroxyl orthiol, and amino is most preferred. The reaction is preferably carriedout at a temperature of from 50° C. to 200° C.

When Q is amino, the intermediate of formula (II) may also exist in theimino form: ##STR6## and when Q is hydroxyl or thiol, the intermediatesof formula (II) may exist in their amide and thioamide forms: ##STR7##

The amidine of formula (II) (Q is --NH₂), can be in salt form, forexample a salt of a mineral acid such as the hydrochloride, and can bereacted with N-methylpiperazine in an organic solvent such as anisole,toluene, dimethylformamide or dimethyl-sulphoxide, preferably at atemperature range of 100° to 150° C.

The amidine is prepared by condensing a thiophene compound of formula##STR8## with an ortho-halonitrobenzene, in the presence of a base, forexample sodium hydride, in a solvent such as tetrahydrofuran or n-butyllithium in tetrahydrofuran, or potassium carbonate or lithium hydroxidein dimethylsulphoxide or aqueous sodium hydroxide in dimethylsulfoxide,or with a tetraalkyl-ammonium salt in a two-phase system, to form anitronitrile of formula: ##STR9## which can be simultaneously reducedand ring-closed to the amidine of formula (II) employing, for example,stannous chloride and hydrogen chloride in aqueous ethanol or,alternatively by reduction with hydrogen and palladium/carbon orammonium polysulphide followed by acid-catalysed ring closure. Theintermediate of formula (IIa) may be isolated using ammonium chloride(NH₄ Cl) or ammonium acetate (NH₄ OAc).

When Q is hydroxyl, reaction (a) is preferably carried out in thepresence of titanium tetrachloride which has the ability to react withthe N-methylpiperazine to form a metal amine complex. Other metalchlorides such as those of zirconium, hafnium or vanadium may also beemployed. The reaction can be carried out in the presence of an acidbinding agent such as a tertiary amine, for example, triethylamine.

Alternatively, the reaction can be carried out using excess ofN-methylpiperazine to act as an acid-binding agent. A suitable organicsolvent such as toluene or chlorobenzene can be used as a reactionmedium, although the use of anisole is particularly desirable, at leastas a co-solvent, in view of its ability to form a soluble complex withTiCl₄.

If desired, elevated temperatures, for example up to 200° C., can beused to hasten the reaction and a preferred temperature range forcarrying out the reaction is from 80° C. to 120° C.

The intermediate amide of formula (II) (Q is --OH) can be prepared fromthe corresponding amidine (Q is --NH2) by alkaline hydrolysis, or can bederived from compounds of formula ##STR10## in which R is an estergroup, preferably C₁₋₄ alkyl, by ring closure employing, for example,sodium methylsulphinyl methanide in a suitable solvent such asdimethylsulphoxide. Alternatively, the amide can be prepared by ringclosure of an amino-acid, employing for exampledicyclo-hexylcarbodiimide (DCC) in a suitable solvent such astetrahydrofuran. The amino-acid can be obtained for example from theabove esters by basic hydrolysis using for example sodium hydroxide inethanol.

Thioamides of formula (II) (Q is --SH), iminothio-ethers, iminoethers oriminohalides, or other derivatives containing active Q radicals asspecified above, tend to be more reactive towards N-methylpiperazine andcan usually be reacted without the necessity for the presence of TiCl₄,but otherwise employing the same conditions of temperature and solvent.

The thioamide of formula (II) (Q is --SH) can be prepared by treating asolution of the corresponding amide in an anhydrous basic solvent, suchas pyridine, with phosphorous pentasulphide. Similarly, the amide can beconverted to the iminothioether, iminoether or iminohalide, or otherderivatives containing active Q radicals, by treatment with conventionalreagents such as for example in the case of the iminochloride,phosphorous pentachloride.

The intermediate compounds of formula (II) in which Q is a radicalcapable of being split off, particularly those in which Q is --NH₂, --OHor --SH and when Q is --NH₂ salts thereof, are novel compounds, and forma further aspect of the present invention.

With regard to reaction (b) above, the compound of formula (III) may bering-closed by employing, for example, titanium tetrachloride ascatalyst and anisole as solvent, and the reaction is preferably carriedout at a temperature of 100° C. to 250° C., for example from 150° C. to200° C.

The intermediate compound of formula (III) is preferably prepared insitu without isolation by reacting a compound of formula ##STR11## inwhich R is an ester group, preferably C₁₋₄ alkyl, withN-methylpiperazine, by heating to a temperature of between 30° C. and120° C., for example about 100° C., in a suitable solvent such as forexample anisole, and employing TiCl₄ as catalyst.

The compound of formula (IV) can be prepared from the correspondingnitro compound of formula ##STR12##

Such compounds of formula (V) in which R is an ester group, such as forexample C₁₋₄ alkyl, are novel and form a further aspect of theinvention.

If convenient this nitro compound can be converted to the amine offormula (IV) without isolation, before reaction with N-methylpiperazine.Intermediate compounds of formula (V) can be made by condensation of athiophene of formula ##STR13## with an ortho-halonitrobenzene,preferably ortho fluoro-or chloro-nitrobenzene, in the presence of abase, for example, (a) sodium hydride in a solvent such as for exampletetrahydrofuran and at a temperature of from -20° C. to 30° C., or (b)anhydrous potassium carbonate or lithium hydroxide in a solvent such asdimethylsulphoxide at a temperature of from 90° C. to 120°C. Thecompound of formula (V) is converted to that of formula (IV) byreduction, for example catalytically, employing hydrogen andpalladium/carbon, or chemically, employing stannous chloride andhydrogen chloride in aqueous ethanol, or ammonium polysulphide, or zincin aqueous ammonium chloride.

It will be appreciated that the compound of formula (I) may be isolatedper se or may be converted to an acid addition salt using conventionalmethods.

As mentioned above, 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno2,3-b! 1,5!benzodiazepine has useful central nervous system activity.This activity has been demonstrated in models using well-establishedprocedures. For example, the compound has been assessed in a number ofstandard behavioral tests predictive of antipsychotic activity. Itantagonized apomorphine-induced climbing behavioral and hypothermia inmice (Moore, N. A. et al. Psychopharmacology 94 (2), 263-266 (1988), and96, 539 (1988)) at doses of less than 10 mg/kg. The compound alsoinhibited a conditioned avoidance response in rats (ED₅₀ 4-7 mg/kg), butunlike standard compounds, it induced catalepsy only at much higherdoses (ED₅₀ 39.4 mg/kg). This separation between the doses required toblock a conditioned avoidance response and to induce catalepsy indicatesthat the compound is less likely to induce extrapyramidal side effectsin the clinic.

The compound 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b!1,5!benzodiazepine was also active at doses of less than 10 mg/kg in atest based on the apomorphine-induced climbing test referred to above,which measured the ability of the compound to prevent the disruption ofclimbing response produced by 24 hour pre-treatment withN-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline (EEDQ), a dopaminereceptor inactivating agent (Meller et al. Central Dl dopaminereceptors, Plenum Press, 1988). This test shows that the compoundpossesses activity at both the D-1 and D-2 receptors.

The 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b!1,5!benzodiazepine compound was active in the multiple conflict scheduleat doses of less than 5 mg/kg. Moore, Nicholas A. et al., The Journal ofPharmacology and Experimental Therapeutics, 545-551, 262: 2 (1992). Thetest measures characteristic changes in rates of responding associatedwith anxiolytic agents. The conflict procedure results are indicative offavorable anxiolytic activity.

The conflict procedure used was based on the method of Geller andSeifter, Psychopharmacoloaia 1: 482-492, (1960). Rats were trained on amultiple schedule consisting of three components. Individual componentswere as follows: 1) for 9 minutes, lever pressing was reinforced on avariable interval 30 second schedule (VI 30, reward). This period wassignaled by illumination of the houselight alone. 2) During thefollowing 3-minute period, lever presses were recorded but had noprogrammed consequence (time-out). 3) Lever pressing was reinforcedaccording to a fixed ratio 10 second food presentation (FR10) for 3minutes; however, each reinforced response was accompanied by anelectric current (0.5 mA) being applied to the grid floor for 500 msec(conflict). This component was signaled by illumination of thehouselight and three cue lights on the front panel. This sequence ofthree components (reward/time-out/conflict) was presented twice in thesame order during the daily 30 minute session. Animals were givenextensive training on this schedule until the following criteria hadbeen satisfied: 1) rates of responding during the individual VI30components did not differ by more than 10%; 2) rates of respondingduring time-out and conflict were less than 10% of the rate during theVI component; and 3) the above criteria were satisfied for a period offive days.

After the training procedure, drug testing was initiated. During thisperiod, the animals were dosed orally with either test compounds orvehicle in a randomized order 60 minutes before testing. At least twodrug-free training days occurred between test sessions. This testindicates that the compound has anxiolytic properties which are notobserved with typical antipsychotic agents. Spealman et al., J.Pharmacol. Exp. Ther., 212: 435-440, 1980.

In addition, 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b!1,5!benzodiazepine has been found to have a favorable profile ofactivity in a number of in vitro binding assays, designed to measure thedegree of binding to neural receptors.

In keeping with the observations made in the behavioral tests, thecompound is active at both the dopamine D-1 and D-2 receptors asindicated by an IC₅₀ of less than 1 μM in the ₃ H-SCH23390 (Billard, W.et al. Life Sciences 35 1885 (1984)) and the 3H-spiperone (Seeman, P. etal. Nature 261 717 (1976)) binding assays respectively.

The compound has an IC₅₀ of less than 1 μM in the ³ H-QNB binding assaydescribed by Yamamura, HI and Snyder, SH in Proc.Nat.Acad.Sci. USA 711725 (1974) indicating that it has antimuscarinic-anticholinergicactivity. In addition, the compound shows its greatest activity at the5-HT-2 receptor in that it displaces -spiperone from binding sites inthe rat frontal cortex (Peroutka, SJ and Snyder, SH Mol. Pharmacol. 16687 (1979)) at low nanomolar concentrations. The compound is also activeat the 5-HT-1C receptor.

This profile of activity in in vitro receptor binding assays, like thatobserved in the behavioral tests, would indicate that the compound iseffective in the treatment of psychotic conditions but is less likely toinduce extrapyramidal side-effects. The behavioral tests and in vitrobinding assays indicate that the compound is an effective anxiolyticagent and is useful for the treatment of other pathologic psychologicalconditions.

The 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b!1,5!benzodiazepine compound is effective over a wide dosage range, theactual dose administered being dependent on the condition being treated.For example, in the treatment of adult humans, dosages of from 0.25 to30 mg, preferably from 1 to 20 mg, per day may be used. A once a daydosage is normally sufficient, although divided doses may beadministered. For treatment of psychotic disorders a dose range of from1 to 20 mg, preferably 2.5 to 15 mg per day is suitable, whereas formild anxiety states a lower dosage range, such as from 0.25 to 5 mg,preferably 1 to 5 mg, may be more appropriate. In choosing a suitableregimen for patients suffering from psychotic illness it may frequentlybe necessary to begin with a dosage of from 1 to 20 mg per day and whenthe illness is under control to reduce to a dosage as low as 1 mg perday. In studies using radiolabelled compound of the invention, residueshave been detected in the saliva and thus the compound can potentiallybe monitored in patients to assess compliance.

The 2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b!1,5!benzodiazepine compound will normally be administered orally or byinjection and, for this purpose, it is usually employed in the form of apharmaceutical composition.

Accordingly the invention includes a pharmaceutical compositioncomprising as active ingredient a compound of formula (I) or apharmaceutically acceptable acid addition salt thereof, associated witha pharmaceutically acceptable carrier. In making the compositions of theinvention conventional techniques for the preparation of pharmaceuticalcompositions may be used. For example, the active ingredient willusually be mixed with a carrier, or diluted by a carrier, or enclosedwithin a carrier which may be in the form of a capsule, sachet, paper orother container. When the carrier serves as a diluent, it may be solid,semi-solid or liquid material which acts as a vehicle, excipient ormedium for the active ingredient. The active ingredient can be adsorbedon a granular solid container for example in a sachet. Some examples ofsuitable carriers are lactose, dextrose, sucrose, sorbitol, mannitol,starches, gum acacia, calcium phosphate, alginates, tragacanth, gelatin,syrup, methyl cellulose, methyl-and propyl-hydroxy-benzoate, talc,magnesium stearate or mineral oil. The compositions of the inventionmay, if desired, be formulated so as to provide quick, sustained ordelayed release of the active ingredient after administration to thepatient.

Depending on the method of administration, the compositions may beformulated as tablets, granules, capsules, depot formulation, injectionsolutions for parenteral use, gel or suspension for transdermaldelivery, suspensions or elixirs for oral use or suppositories.Preferably the compositions are formulated in a dosage unit form, eachdosage containing from 0.25 to 30 mg, more usually 1 to 20 mg, of theactive ingredient. A preferred formulation of the invention is a capsuleor tablet comprising 0.25 to 30 mg or 1 to 20 mg of active ingredienttogether with a pharmaceutically acceptable carrier therefor. A morepreferred formulation is a tablet comprising 1, 2.5, 5, 7.5 or 10 mg ofactive ingredient together with a pharmaceutically acceptable carriertherefor. A further preferred formulation is an injection which in unitdosage form comprises 0.25 to 30 mg or 1 to 20 mg of active ingredienttogether with a pharmaceutically acceptable diluent therefor. A type ofinjection formulation that is especially desirable is a sustainedrelease formulation for intra-muscular injection. Another preferredformulation is a granule formulation. The granule formulation may serveas a reconstitutable solid.

The invention is illustrated by the following Examples.

EXAMPLE 1

1. 2-Amino-5-methvlthiophene-3-carbonitrile

A mixture of sulfur (217.8 g, 6.79 mol), propional-dehyde (472.5 g, 587mL, 8.13 mol) and dimethylformamide (1350 m) was placed in a 5 litreflange-necked flask fitted with air stirrer, air condenser, long reachthermometer and dropping funnel. Triethylamine (576 mL, 4.13 mol) wasadded dropwise over 30 minutes to the cooled stirred reaction mixturewhilst maintaining the pot temperature between 5°-10° C. with anice-bath. After addition was complete the pot was allowed to warm up to18° C over 50 minutes, keeping the mixture well stirred. Then a solutionof malononitrile (450 g, 6.8 mol) in dimethylformamide (900 mL) wasadded dropwise over 70 minutes keeping the pot temperature around 20° C.throughout the addition. After addition was complete the mixture wasstirred at 15°-20° C. for a further 45 minutes then sampled for TLC. Themixture was then poured onto ice (4 litres)/water (8 litres) withstirring and this caused the required product to precipitate. After 10minutes the stirrer was switched off and the solid allowed to settle.The aqueous liquor was decanted away and the solid isolated byfiltration. The isolated solid was well washed with water (de-ionized, 4litres), then dried over night in vacuo at 70°-75° C. to give the titlecompound (585 g), m.p. 100° C.

2. (2-(2-Nitroanilino)-5-methylthiophene-3-carbonitrile

To a stirred slurry of sodium hydride (14.4 g, 50% dispersion in oil,0.3 mol) in dry tetrahydrofuran (50 mL) under nitrogen was added,dropwise, a solution of 2-fluoro-nitrobenzene (28.2 g, 0.2 mol) and2-amino-5-methylthiophene-3-carbonitrile (27.6 g, 0.2 mol) in drytetrahydrofuran (250 mL). The mixture was stirred at 25° C. for 24hours, poured onto cracked ice and extracted into dichloromethane (3×500mL). The combined extracts were washed with 2N hydrochloric acid (2×200mL), water (2×200 mL), dried over magnesium sulfate and the solventremoved under reduced pressure. The residue was crystallized fromethanol to give the title compound, (35.2 g) , m.p. 99°-102° C.

3. 4-Amino-2-methyl-10H-thieno 2,3-b! 1,5!benzodiazepine, hydrochloride

To a stirred slurry of2-(2-nitroanilino)-5-methyl-thiophene-3-carbonitrile (3 g, 0.011 mol) inethanol (35 mL) at 50° C. was added, over 10 minutes, a solution ofanhydrous stannous chloride (6.95 g, 0.037 mol) in hydrochloric acid (26mL, 5M). The mixture was stirred under reflux for 1 hour, concentratedunder reduced pressure and allowed to crystallize over night at 5° C.The salt was filtered, washed with a small amount of water, dried (4.3g) m.p.>250° C., and used without further purification in the nextstage.

4. 2-Methyl-4-(4-methyl-1-piperazinyl)-10H-thieno 2,3-b!1,5!-benzodiazepine

Crude 4-amino-2-methyl-10H-thieno 2,3-b! 1,5!benzo-diazepine,hydrochloride (4.3 g) was refluxed in a mixture of N-methylpiperazine(15 mL), dimethylsulphoxide (20 mL) and toluene (20 mL) under a nitrogenatmosphere for 20 hours. The mixture was cooled to ca. 50° C., water (20mL) added, and the product allowed to crystallize at 5° C. over night.The product was filtered and crystallized from acetonitrile (30 mL) togive the title compound (1.65g) m.p. 195° C.

The structure of the compound was confirmed spectroscopically: ##STR14##

¹ H NMR (CDCl₃) δ 2.30 (3H, s, 4'-CH₃), 2.28 (3H, s, 2-CH₃), 2.45 (4H,m, 3'-CH₂) 3.49 (4H, m, 2'-CH₂), 5.00 (H, broad s, 10-NH), 6.23 (H,broad s, 3-CH), 6-35-7-10 (4H, m, 6,7,8,9-H).

³ C NMR (CDCl₃) δ 128.5 (s, C-2), 127.8 (d, C-3), 119.1 (s, C-3a), 157.4(s, C-4) 140.8 (s, C-5a), 123.4, 122.6, 124.1 (d, C-6,7,8), 118.8 (d,C-9), 142.5 (s, C-9a), 151.8 (s, C-10a), 46.5 (t, 2'-C), 54.8 (t, 3'-C)45.9 (q, -4'-C), 15.2 (q, 2-Me).

Mass spectra shows an M+of 312 and major fragment ions of m/z 255, 242,229 and 213.

EXAMPLE 2

1. Methyl 2-amino-5-methylthiophene-3-carboxylate

To a stirred mixture of methyl cyanoacetate (3.9 g, 0.04 mol), sulfur(1.26 g, 0.04 mol) and triethylamine (3.2 mL, 002 mol) in drymethylformamide (12 mL) under a nitrogen atmosphere at 45° C. was added,dropwise, a solution of freshly distilled propionaldehyde (2.5 g, 0.043mol) in dry dimethylformamide (2 mL), keeping the temperature at 45°-47°C. The mixture was stirred at 45° C. for 1.5 hours, then partitionedbetween water and ethyl acetate. The organic extract was washed withwater, dried and evaporated. The title compound was purified bychromatography on neutral alumina, eluting with chloroform-hexane (4.8g).

2. Methyl 2-(2-nitroanilino)-5-methvlthiophene-3-carboxvlate

To a stirred suspension of sodium hydride (2 g) in dry tetrahydrofuran(25 mL) under a nitrogen atmosphere was added a solution of methyl2-amino-5-methylthiophene-3-carboxy-late (4.8 g, 0.028 mol) and2-fluoronitrobenzene (4.0 g, 0.025 mol) in dry tetrahydrofuran (30 mL).The mixture was stirred at 25° C. for 20 hours, poured onto ice andpartitioned between 2N hydrochloric acid and ethyl acetate. The organicextracts were dried over magnesium sulfate, the solvent was evaporatedunder reduced pressure and the title compound purified by chromatographyon silica gel, eluted with toluene, and crystallized from ethanol (4.1g).

3. 2-Methyl-4-(4-methyl-1-piperazinyl)-10-thieno 2.3-b!-1,5!-benzodiazenine

Methyl 2-(2-nitroanilino)-5-methylthiophene-3-carboxy-late (3.7 g,0.0013 mol) was hydrogenated in a Parr apparatus at 60 psi inethanol-ethyl acetate (2:1, 150 mL) with palladium on charcoal catalyst(10%, 200 mg). After removal of catalyst and solvent the crudediamino-ester was dissolved in a mixture of N-methylpiperazine (21 mL)and anisole (55 mL). To this solution, under a nitrogen atmosphere wasadded, with stirring, a solution of titanium tetrachloride (3.45 mL) inanisole (15 mL). The mixture was stirred at 100° C. for 1 hour, thenunder reflux for 48 hours to effect ring closure of 1-{ 2-(2-aminoanilino)-5-methylthiophen-3-yl!carbonyl}-4-methylpiperazine.

After allowing to cool to 80° C. a mixture of 30% ammonia solution (10mL) and isopropanol (10 mL) was cautiously added, followed by ethylacetate (25 mL). The inorganic precipitate was removed by filtration andthe filtrate washed with water (3×25 mL), dried with magnesium sulfateand the solvent removed under reduced pressure. The product was purifiedby chromatography on Florisil, eluted with ethyl acetate and finallycrystallized from acetonitrile (40 mL) to give the title compound (2.32g), identical with that described above.

EXAMPLE 3

A pulvule formulation is prepared by blending the active with siliconestarch, and filling it into hard gelatin capsules.

    ______________________________________                                                       Per 300 mg capsule                                             ______________________________________                                        Compound of the invention                                                                      5.0 mg                                                       Silicone         2.9 mg                                                       Starch flowable  292.1 mg                                                     ______________________________________                                    

EXAMPLE 4

A tablet formulation is made by granulating the active with appropriatediluent, lubricant, disintegrant and binder and compressing

    ______________________________________                                        Compound of the invention                                                                            5.0    mg                                              Magnesium stearate     0.9    mg                                              Microcrystalline cellulose                                                                           75.0   mg                                              Povidone               15.0   mg                                              Starch, directly       204.1  mg                                              compressible                                                                  ______________________________________                                    

EXAMPLE 5

An aqueous injection of active is prepared as a freeze-dried plug, forreconstitution in a suitable, sterile 25 diluent before use (to a totalvolume of 10 ml).

Compound of the invention Mannitol N Hydrochloric acid and/or N sodiumhydroxide to adjust pH to 5-5.5.

    ______________________________________                                        Compound of the invention                                                                         20.0 mg                                                   Mannitol            20.0 mg                                                   N Hydrochloric acid and/or N                                                  sodium                                                                        hydroxide to adjust pH to 5-5.5.                                              ______________________________________                                    

EXAMPLE 6

A controlled release injection for intramuscular injection is formedfrom a sterile suspension of micronised active in an oleaginous vehicle.

    ______________________________________                                        Compound of the invention                                                                            65.0   mg                                              Aluminium stearate     0.04   mg                                              Sesame oil             2      ml                                              ______________________________________                                    

EXAMPLE 7

A formulation is prepared by blending the active with silicone starchand starch, and filling it into hard gelatine capsules.

    ______________________________________                                                       Per 290 mg capsule                                             ______________________________________                                        Compound of the invention                                                                       2.5 mg                                                      Starch flowable with 0.96%                                                                     217.5 mg                                                     silicone 220                                                                  Starch flowable   70.0 mg                                                     ______________________________________                                    

We claim:
 1. A method for treating a patient suffering from orsusceptible to a pathologic psychological condition selected from thegroup consisting of Alcohol Withdrawal Delirium; Alcohol Hallucinosis;Alcohol Dementia Associated with Alcoholism; Amphetamine or SimilarlyActing Sympathomimetic Intoxication; Amphetamine or Similarly ActingSympathomimetic Delirium; Amphetamine or Similarly ActingSympathomimetic Delusional Disorder; Cannabis Delusional Disorder;Cocaine Intoxication; Cocaine Delirium; Cocaine Delusional Disorder;Hallucinogen Hallucinosis; Hallucinogen Delusional Disorder;Hallucinogen Mood Disorder; Hallucinogen Posthallucinogen PerceptionDisorder; Phencyclidine (PCP) or Similarly Acting ArylcyclohexylamineIntoxication; Phencyclidine (PCP) or Similarly ActingArylcyclohexylamine Delirium; Phencyclidine (PCP) or Similarly ActingArylcyclohexylamine Delusional Disorder; Phencyclidine (PCP) orSimilarly Acting Arylcyclohexylamine Mood Disorder; Phencyclidine (PCP)or Similarly Acting Arylcyclohexylamine Organic Mental Disorder NOS;Other or Unspecified Psychoactive Substance Intoxication; Other orUnspecified Psychoactive Substance Delirium; Other or UnspecifiedPsychoactive Substance Dementia; Other or Unspecified PsychoactiveSubstance Delusional Disorder; Other or Unspecified PsychoactiveHallucinosis; Other or Unspecified Psychoactive Substance Mood Disorder;Other or Unspecified Psychoactive Substance Personality Disorder; andOther or Unspecified Psychoactive Substance Organic Mental Disorder NOS;comprising administering an effective amount of2-methyl-4-(4-methyl-1-piperazinyl) -10H-thieno- 2,3-b!1,5!benzodiazepine, or an acid addition salt thereof, to the patient. 2.A method of claim 1 wherein the condition is Alcohol Dementia Associatedwith Alcoholism; Amphetamine or Similarly Acting SympathomimeticIntoxication; Other or Unspecified Psychoactive Substance Mood Disorder;Other or Unspecified Psychoactive Substance Personality Disorder; Otheror Unspecified Psychoactive Substance Organic Mental Disorder NOS;Hallucinogen Mood Disorder; Phencyclidine (PCP) or Similarly ActingArylcyclohexylamine Intoxication; Phencyclidine (PCP) or SimilarlyActing Arylcyclohexylamine Mood Disorder; Phencyclidine (PCP) orSimilarly Acting Arylcyclohexylamine Organic Mental Disorder NOS; Otheror Unspecified Psychoactive Substance Intoxication, or Other orUnspecified Psychoactive Substance Dementia.
 3. A method of claim 1wherein the effective amount is from 1 to 20 mg per day.
 4. A method oftreating a patient suffering from or susceptible to a pathologicpsychological condition selected from the group consisting of AlcoholWithdrawal Delirium; Alcohol-Induced Psychotic Disorder, WithHallucinations; Alcohol-Induced Persisting Dementia; Amphetamine Abuse;Amphetamine, Cannabis, Cocaine, Hallucinogen, Inhalant, Opioid,Phencyclidine, Sedative, Hypnotic or Anxiolytic Intoxication Delirium;Amphetamine-, cannabis-, Cocaine-, Hallucinogen-, Inhalant-, Opioid-,Phencyclidine-, Sedative-, Hypnotic-, Anxiolytic-or Other (or Unknown)Substance-Induced Psychotic Disorder; Cocaine Abuse; Hallucinogen Abuse;Amphetamine-, Cocaine-, Hallucinogen-, Inhalant-, Opioid-,Phencyclidine-, Sedative-, Hypnotic-, Anxiolytic-or Other (or Unknown)Substance-Induced Mood Disorder; Hallucinogen Persisting PerceptionDisorder; Phencyclidine, Inhalant or Other (or Unknown) Substance Abuse;Inhalant-, Sedative-, Hypnotic-, Anxiolytic-or Other (or Unknown)Substance-Induced Persisting Dementia; Phencyclidine-Related DisorderNOS; Other (or Unknown) Substance-Induced Delirium; Other (or Unknown)Substance Intoxication; or Other (or Unknown) Substance-Related DisorderNOS; comprising administering an effective amount of2-methyl-4-(4-methyl-1-piperazinyl)-lOH-thieno- 2,3-b!1,5!benzodiazepine, or an acid addition salt thereof, to the patient. 5.A method of claim 4 wherein the effective amount is from 1 to 20 mg perday.